Provider Demographics
NPI:1922863588
Name:KLAPPERICH, KEITH RONALD
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:RONALD
Last Name:KLAPPERICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-1869
Mailing Address - Country:US
Mailing Address - Phone:425-610-7316
Mailing Address - Fax:
Practice Address - Street 1:109 S 10TH ST
Practice Address - Street 2:
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-1869
Practice Address - Country:US
Practice Address - Phone:425-610-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor